Organization
ALAMEDA DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD C SELIS D.M.D. (PRESIDENT)
(503) 287-1554
Entity
Organization
Contact information
Practice address
2422 NE FREMONT ST, PORTLAND, OR 97212-2509
(503) 287-1554
Mailing address
2422 NE FREMONT ST, PORTLAND, OR 97212-2509
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6582
OR
Other
Enumeration date
09/20/2012
Last updated
09/20/2012
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